Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Wednesday, October 08, 2008

Moral Values

As I have noted upon occasion, the moralistic approach to public health is about as immoral as you can get, because it kills people. I'm talking about murderous policies such as abstinence only sex education, banning use of HIV prevention funds for condom distribution, that sort of thing.

Since 1988, Congress has banned federal funding of syringe exchange programs. We must lift this ban.

At the end of 2006, nearly one-third of all U.S. AIDS cases -- more than 300,000 -- were linked to intravenous drug use. These are not just numbers but thousands of Americans -- friends, relatives and colleagues -- struggling with what can be debilitating challenges. Drug addiction can ruin lives, but even its enormous power pales in comparison to the havoc wreaked by HIV. While we strive to help people overcome drug addiction, we must also help them avoid HIV-AIDS and other infectious diseases.

Last year, in an annual spending bill that I wrote, I was able to lift a congressionally mandated ban on the District of Columbia using its own funds for syringe exchange programs. I believe that this was both a home-rule issue and a positive public health initiative. During debate on this measure, critics trotted out the tired claim that syringe exchange programs encourage drug use.

The facts do not support this claim. Consider what Elias A. Zerhouni, the respected director of the National Institutes of Health, wrote to Congress in 2004: "A number of studies conducted in the United States have shown that syringe exchange programs do not increase drug use among participants or surrounding community members and are associated with reductions in the incidence of HIV, hepatitis B, and hepatitis C in the drug-using population." Despite overwhelming scientific evidence, legislators and others opposed to syringe exchange continue to ignore the proof that contradicts their claims.

Obviously, it's too late for the legislation this year. But next year, this will be one more bit of toxic waste from the last eight years that we'll be able to dispose of properly. I know which of the presidential candidates would sign this bill, and which of them would not. So do you.